Lymphatic System Flashcards
What is the key function of the lymphatic system?
Immune defense and transport and drainage of excess fluids, proteins, cellular debris from interstitial spaces
plays a role in maintaining homeostasis
What kind of system is the lymphatic?
“drainage or sanitation” system
one-way system designed to transport lymph through a system of deep/superficial vessels and lymph nodes
What does the lymphatic system include?
- nodes
- thymus
- bone marrow
- spleen
- tonsils
- Peyer patches of small intestine
What is the normal functions of lympathic system?
- remove waste products
- remove excess fluid
- alert the immune system
- return fluid and plasma proteins to the blood
What is transport capacity?
Amount of fluid the system can move when working at max intensity
Under normal conditions, what percentage does transport capacity work at?
~ 10% of normal capacity
What is functional reserve?
The difference between the TC and amount of fluid that is being transported at rest
known as the “lymphatic load” (LL)
What are the causes of lympathic system insufficiency?
- Dynamic
- Mechanical
- Combined
What is dynamic insufficiency?
literally anything that needs the LL to work harder
Ex: ankle sprains
What is mechanical insufficiency?
Damage to the lympathic system = unable to handle the increased LL
- anything that reduces the transport capacity = lower ability to get fluid out
Ex: surgery, infection or trauma
When does lymphedma develop?
When the TC drops below the LL amount = fluid build up in subcutaneous tissue
Lymphedema
high protein causes what?
Fibrosis and sclerosis of the tissues and increases risk of infection
- progressive disorder if left untreated
Lymphedema
What is the primary diagnosis?
Caused from abnormally developed lymphatic system (congential)
Lymphedema
What is the secondary diagnosis?
Caused from known injury to the system
Lymphedema
What are the risk factors?
- excess weight increases the risk
- significant factors for developing lymphedema which includes arm infection/injury
Lymphedema
What are the clinical presentations?
- slow progression
- mild warmth
- rarely see color changes
- usually, painless
- sensation of fullness or heaviness in the limb
- pitting edema or hard to palpate
- asymmetrical comparison of limbs
Differential dx
Lymphedema is has a ____ stemmer sign
positive
Differential dx
General edema has ____ stemmer sign
Negative
Differential dx
What are the signs and sx of lymphedema?
- pitting edema
- underlying fibrosis of skin
- tight and heavy limb
- decreased mobility or loss of ROM
- tingling or numbness in surrounding joints
- skin discolorations
- common fungal discolorations
- hardening of the skin
- odor
- wounds
- decreased QOL
Differential dx
What are the signs and sx of acute edema?
- rapid onset
- red
- warmth
- painful to palpate or movement
- localized
Differential dx
What are the signs and sx of chronic edema?
- skin changes (hair loss)
- loss of tissue elasticity or skin creases
- moderate warmth
- hemosiderin staining
- achy pain progressive through the day
- loss of normal contour in extermity
Lymphedema Stages
Stage 0 characteristics
Latency
- no clinical edema
- negative stemmer sign
- tissue and skin appear normal
- lymph transport capacity already reduced
Lymphedema Stages
Stage 1 characteristics
Reversible
- edema preesent (soft and pitting)
- edema reversible with elevation
- edema increases with standing and activity
- negative stemmer sign
- normal tissue
Lymphedema Stages
Stage 2 characteristics
Spontaneously irreversible stage
- edema present
- initially may still be soft and pitting in early stage 2 but progresses to nonpitting “brawny” edema
- edema does not reverse with elevation
- positive stemmer sign
- tissue looks fibrosclerotic; proliferation of adipose tissue
- frequent infections
- skin changes
Lymphedema Stages
Stage 3 characteristic
- edema present
- severe “brawny” nonpitting edema
- edeema does not reverse with elevation
- positive stemmer sign
- tissue looks fibrosclerotic
- proliferation of adipose tissue
- frequent infections
- skin changes
What is the treatment of lymphedema?
- dependent on the TYPE
- primary is treated conservatively
- secondary needs treatment of the cause first then proceed to conservative treatment
What happens when lymphedema is left untreated?
Can lead to an increased risk of cellulitis
What are the medication management for lymphedema?
edema management
or
primary disease exacerbations
What are the causes of cellulitis?
infection of the skin caused by bacteria
Cellulitis
When does it commonly occur?
when the integumetary system has an open wound for bacteria to get into
- strep/staph
Cellulitis
What is the symptoms?
- redness
- edema
- tenderness
- pain
- warm skin
- blisters
- fever
- headaches
- chills
- weakness
- red streaks
Cellulitis
When does it become a medical emergency?
if the area spreads and becomes large
- skin changes colors (red to black)
- affects the face
- weakened immune system
Cellulitis
How is it diagnosed?
Blood test
skin culture
Cellulitis
What is the treatment?
- antibiotics
- topical antibiotics
- wound dressing
- pain meds PRN
- surgery
Cellulitis
What are the complications?
- extensive tissue damage
- gangrene
- infection could spread to blood or other systems
could lead to sepsis, amputation, shock or death
Cellulitis
What is the prevention?
- hygiene
- protecting dry skin
- protective footwear
- wound prevention
